Bo Lönnerdal, Ollehernell.
Under and Over Nutrition of Iron in Infancy and Early Childhood.
Pak Paed J Nov ;38(2):132-3.

KEY MESSAGES Iron supplementation/fortification will prevent iron deficiency and iron deficiency anemia in many infants who need iron, but infants with adequate iron status provided iron may be at risk for adverse outcomes. Under nutrition of iron, or what we usually call iron deficiency (ID), is the most common micronutrient deficiency in older infants and toddlers in both under privileged and privileged countries1. It is caused by a high requirement for iron due to rapid growth, a lack of iron in the diet and/or poor bioavailability of the dietary iron. ID in its pronounced form causes anemia (IDA) and is a risk factor for poor health2. IDA may, in turn, cause delays in cognitive and motor development3, and these impairments appear to be irreversible, i.e. even with iron treatment can the deficits be manifested at older age. To prevent these long-term effects on the development, the provision of iron supplements4 or for tifi-cation5 of commonly used foods is recommended, coupled with dietary advice on how to select iron-rich foods The possibility of over nutrition of iron, i.e. excessive iron provision, has received limited attention. Although iron can cause accidental poisoning due to its toxicity, it has generally been believed that the doses of iron provided in iron supplements and iron fortified foods are modest and that any excess would be excreted. However, some studies suggest that providing iron to infants with adequate iron stores may have adverse effects. Iron drops given to iron-replete Honduran and Swedish infants aged from 4 to 9 months resulted in significantly decreased length gain6. This adverse effect was not observed in infants who initially had a low iron status. Several other studies in developing countries7–9 have shown decreased weight gain in infants who were iron replete at the start of the supplementation.

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